The lumbar (lower back) spine is made up of 5 vertebrae stacked on top of each other separated by discs. A disc comprises many layers of strong connective tissue wrapping around the disc. The centre of the disc comprises a soft jelly like substance .
What is a disc bulge?
A disc bulge is where the jelly like substance within a disc protrudes through tears in the layers of connective tissue. Most discs bulge in a postero-lateral direction and predominantly effect the L5S1 (lowest ) lumbar vertebrae followed by L4L5.
What causes a disc to bulge?
A disc can bulge following either a traumatic incident or over a prolonged period. Bending forward is the most common way to injure a disc, especially if this includes an element of twisting. There are often reports of simple activities such as bending over to pick something up, or sneezing that injure the disc. In these instances there would usually have been some damage prior to such a simple incident over a prolonged period of time.
What are the symptoms of a lumbar disc bulge?
Symptoms usually include a sudden onset of back pain whilst performing the provocative activity or the following morning after performing the provocative activity. Pain may be felt centrally in the lower back or predominantly to one side. There is usually a dull ache with sharp pain on particular movements, often those involving bending forwards or coughing and sneezing. Pain may radiate into the buttocks (usually one side) or down the leg into the foot, known as sciatica. Numbness, pins and needles or weakness may be felt in the leg or foot . There may be muscle spasm present in the muscles surrounding the spine.
Physiotherapy for lumbar disc bulges may include?
Physiotherapy for lumbar disc bulges may include:
- Joint mobilisations
- Soft tissue massage & trigger point releasing
- Acupuncture / dry needling
- Electrotherapy such as ultrasound or interferential therapy
- Postural taping
- Postural advice
- Home stretching exercises
- Core abdominal strengthening exercises
- Clinical Pilates
Prognosis for lumbar disc bulges.
Most people with a disc bulge will see an improvement within 10-14 days with appropriate physiotherapy treatment, however some people experience pain for months. For those severe cases your physio may refer you to an orthopaedic consultant and cortisone injections to reduce inflammation or surgery may be required.
What should I do if I think I have a lumbar disc bulge?
Call the physio at Back2Balance Physiotherapy to make an appointment on 3352 5311 for an assessment and advice.